The primary purpose of this research is to develop and evaluate the effectiveness of an innovative multiple behavior screening, brief intervention and referral to treatment (MB-SBIRT) model using social and self-image to simultaneously link and reduce prescription and other drug abuse and other co-occurring risk behaviors among emerging adults in primary care settings serving racially and economically diverse communities. The long term objective of this research is to cost-effectively reduce prescription and illicit drug abuse, along with alcohol and tobacco consumption and HIV/AIDS risk behaviors, and improve health-related quality of life among high-risk emerging adults often ignored in intervention research and services. Emerging adults have the highest levels of prescription, illicit and licit drug consumption of any age group in the nation. This work is founded on an emerging conceptual framework titled the Behavior-Image Model (BIM), which posits that multiple health behaviors can be coupled and simultaneously influenced with brief interventions targeting salient social and self-images. The proposed research will involve two primary phases. The first phase will consist of formative research activities involving the use of expert panels, target audience surveys, and pilot testing. A randomized controlled pilot test will be conducted examining the acceptability, quality, feasibility, and short-term (3-month) effects of two community-friendly computer technology delivery formats of the MB-SBIRT model for young adult patients attending four participating primary care clinics. Training of all medical personnel will be conducted to increase acceptance and utilization of the MB-SBIRT model, and brief computer-generated summary reports on perceived patient quality, utilization and effectiveness will be provided to medical staff on a regular basis to enhance sustainability of the proposed SBIRT model within participating primary care clinics. The second phase of the proposed research design and methods will involve a longitudinal randomized clinical trial (RCT) of the effects of the revised MB-SBIRT model. This phase is essential to determining the short (3-month) and long-term (1-year) effectiveness, costs, and cost-effectiveness of the innovative MB-SBIRT model among young adults attending participating primary health clinics in diverse communities in northeast Florida. This second phase of research will also determine the role of baseline drug use, gender, race, and clinic setting as moderators of the MB-SBIRT model effects at both follow-up data collection points. In addition, we propose to evaluate social and self-image and other theory-based risk factors as mediators of change on prescription and illicit drug use and problems, alcohol and tobacco use, HIV/AIDS risk behaviors, health-related quality of life, and attempts to seek drug abuse and HIV/AIDS treatment and testing at both follow-up data collection points. Project